Last Days in Hinche

My last days in Hinche were very busy.  I am home now, so I will write a recap of last Thursday, Friday and Saturday.

Thursday morning, I went in the pink jeep to Darlegrand for mobile clinic.  There was the driver, me, 3 midwives, 2 midwife students and my interpreter.  And of course all the gear to do clinic.  Sort of like when I do village clinics in Alaska, but I fly to those.  It was little over an hour's drive in the pink jeep to get to Darlegrand over very rough roads.  Got stuck once and was pulled out by a dump truck.  It was great to be able to see the countryside on the way there.

The women were already waiting when we arrived there.  We unloaded all of our gear and set up the clinic in a small concrete room.  The women waited on a covered patio.  While we were setting up inside, one of the midwives was doing some education on breastfeeding.

Each woman came in one at a time with a urine sample.  The urine was tested for glucose, protein, chlamydia and gonorrhea.  Her finger was then pricked and the blood sample was tested for HIV and RPR.  Her weight was taken and then she stepped outside with her tests in hand.  When all the women had done this, the midwife outside took each one's blood pressure and then sent her back in.  The first midwife recorded her BP and test results.  For women whom it was her initial visit, she also did her history and started a chart for her.  The second midwife gave each woman her appropriate meds:  prenatal vitamins, iron, Vitamin C, perhaps apresoline or a shot for a positive gonorrhea (there were 4 of those).  Oral meds were given for the partners of the women who were positive for gonorrhea.  The woman would then come to me and my two midwife students.  We had brought a massage table to use.  We did fundal heights, fetal position and fetal heart tone checks.  It was a very organized system.  And such a wonderful service that these midwives provide!  They do mobile clinics to 16 different villages.

After all the women were seen, it was then time to load up and head back to Hinche.

The 3 midwives & 2 students @ mobile clinic.

Ronel, our driver, loading up the pink jeep.

When I returned to the house after mobile clinic there were a bunch of new people there.  It was Cristy Turlington who founded Every Mother Counts with her film crew!  http://www.everywomancounts.org  She is supporting this current class of midwives.  It is just so awesome what she has done, and still does, to help save mothers around the world.  The two brothers from the orphanage also came to dinner.  What a houseful!

Me and Cristy Turlington making baby packs with some of the items my mom made.

A new program that Midwives for Haiti has begun is teaching the matrons, or traditional birth attendants in the different villages.  The matrons deliver 70% of the babies in Haiti.  These classes are being taught by graduate midwives.  They teach cleanliness at births, danger signs, when a mom should be transported to the hospital, etc.  On Friday morning I went to a graduation of a group of these matrons that had just finished the 5 month training program.  They were very proud of their accomplishment!  I felt privileged to share this graduation with them.

 There were 6 male matrons in this group.  One of the male matrons has been delivering babies for 43 years!

They say that it is a calling to become a matron.

Each graduate put her/his thumbprint and initials next to their name.

Each Friday the entire class is in the classroom at the house to present case studies of what they had encountered during the week.  They had several cases to study on this Friday:  a previa at 7 months, a baby born with an omphalocele, a hydraencephalic baby (neither of those babies survived), primip with an arrested labor that ended up with a c-section, a grand multip with preterm labor, a pre-eclamptic mom.  I am very impressed with these students, their professionalism, and how much they are really learning.  It was an extreme pleasure to work with them this week!

Current class of student midwives.

After the case study class, other midwives began bringing dishes of food.  As it turned out, midwives from every class had planned a surprise party for Nadene and Dr. Steve!  It was a party to give them thanks for founding and continuing Midwives for Haiti.  What a celebration.  There were many speeches, songs and poems of gratitude for all Nadene has done for them.

A graduate midwife with Carrie, who manages the house and coordinates all of the volunteers.

Saturday was my last day in Hinche, Haiti :-(  Dr. Alice and I were driven the three hours to the Port au Prince airport.  One last look at the Haitian countryside on the way to the airport.  I was sort of nervous to go to Haiti, but I am SO glad I did!  What an amazing experience.  And I hope it won't be my last trip there.  I am very impressed with what Midwives for Haiti have accomplished and continue to do.  Anytime any of you could donate to them to help them out with their work, it would be most welcome (http://www.midwivesforhaiti.org).  I can now tell you from personal experience that it is a most worthy cause.

Love,

Zelda

On My Way Home

I'm on my way home.  I'm at the Atlanta airport waiting for my flight to Seattle.  Sorry I didn't write anything on Thursday and Friday.  I was just so busy from early morning until late at night.  Once I get home (tomorrow afternoon), I will fill you in on my last two days in Hinche!  What an AWESOME trip I had!

Hump Day

I went to the hospital again today.  Different students from Monday and Tuesday.  I spent first half of day in postpartum and second half of day at L&D.  In L&D I was assigned one patient and one midwife student, but there also were 2 nursing students with us.  Primip in active labor.  The signs of a woman having back labor is the same no matter what part of the world you're in.  As per usual around here, those three were just watching the mom standing, rocking, bending over, moaning.  I immediately began giving lower back pressure, massage.  The mom just leaned into.  Ah!  That's what I needed.  After that the midwife student and nursing students would also take turns rubbing her back during contractions.  There's no room in L&D for any family members.  We checked her and she was only 6.  So I sent her outside the unit (which is outside in the courtyard). There, her female family members took over.  Walking with her, rubbing her back, etc.  So much better being outside with her support system, then in the cramped, very crowded L&D!  Unfortunately, she didn't deliver before I left, I'm sure she did fine.

Dr. Alice wanted to go to town to buy a little wooden chair for her kid.  I just went along for the adventure.  We each had our taxi (motorcycle).  It was cool to see the hustle and bustle downtown.  Well, I shouldn't say hustle.  NOBODY hustles around here for anything, it's the Haitian pace.

The young Irish pediatrician came over this evening.  I've worked with her this week, and she is awesome!  Speaks fluent French.  That's a great asset here, next to knowing Haitian Creole, that is.  We all had a lively discussion about working at St. Therese Hospital.

I do feel a lot better today.  So glad they have a supply of Cipro here!  Plan on going on mobile clinic tomorrow.

First photo is of the Midwives for Haiti jeep.  It's what they use to pick up people at the airport in Port au Prince.  So I have already been on a 3 hour ride in it.  They also use it for the mobile clinics.  They do mobile clinics to 16 villages!  From what I understand the jeep is really in some need of some major repair.  They don't really have that kind of money, so they make repairs as they can.

The first photo is of the pink jeep.  The other photos are from our trip to town.

Montezuma's Revenge

Well, at least that's what they call it in Mexico.  After only having a piece of toast with pb& j on it, had a bout of  diarrhea (possibly TMI =-). Took Pepto Bismol tablets every hour X 3 hours while at hospital.  Made it through my shift at the hospital.

I was the preceptor for same two nursing students.  Me, them and a midwife took care of the postpartum ward again.  Although there were only 4 postpartum women, three pregnant women (1 preeclampsia, 1 preterm labor and 1 with a placenta previa).

When I got home, I had some lunch and then just felt I had to lay down.  I crashed for a couple hours.  I think it all just caught up to me,  diverted flights, lost bags, 4 hour time difference.  The other 3 that arrived the day I did, were still in their own time zone.  They're all from Virginia.  And I have been trying to keep up with them all since I got here.  I actually feel much better after my nap.  I may go on a field clinic tomorrow.  But we haven't decided who is going to be where.

Today Sarah, CPM, and I shared a mototaxi on way to hospital.  On the way home I rode with Dr. Steve and Dr. Alice on the house's 3 wheeler.

First photo is of a baby that was born yesterday.  Second one is the 3 of us on the 3 wheeler leaving the hospital, still on hospital grounds. The third is of the class that was going on when I got to the house this afternoon.  They currently have two midwife classes going.  One is at clinical Monday and Tuesday, the other in classroom.  Then they switch for Wednesday and Thursday.  I don't know yet what they do in Friday.

Monday, Monday

Today I spent my first day at the hospital.  Carrie arranged for a "taxi" to take us both.  The taxis are motorcycles!  And the roads are gravel.  I think he was probably driving slower than he usually does because he had me and Carrie on the back (2 white women).

I had a great interpreter named Shirley.  She really knows her way around the maternity part of the hospital.  I worked with 2 midwife students and their preceptor.  Tomorrow I will be their preceptor.  I think we'll be assigned to postpartum again.  Today when it was slower, Shirley and I spent time at L&D.  Very busy day there today with the OB handling a miscarriage, 3 midwives, 1 midwife preceptor and 4 midwife students.  There were also a bunch of nursing students there.  It made a very small space very crowded.  Shirley and I also put away in the storage room a bunch of supplies that one of our doctors had brought with them to donate.

The postpartum unit consists of 10 beds in a ward like setting.  4 postpartum women were there with their babies.  There were also 2 older women being assessed/treated for uterine cancer.  There are 3 rooms in L&D.  One of the rooms has two Exam rables, the other rooms one each.  When it was really busy, one of the midwives did a few assessments in the storage room (like BP's, fetal heart tones, etc)

Kenel is a 25 year old guy that comes here each evening to offer Creole lessons for $5.  I attended his class on the patio yesterday and today.  He's really funny and has taught some useful Creole phrases to use.

Each evening I've also gone on a walk with the other providers here.  We walk the trails behind our house through some bucolic fields.  There are small houses scattered around, burros, goats and horses.  Along with other people walking or tending to their yards and/or animals.

Oh! And my bags arrived!  Everything was still in them.  I finally get to start distributing the things that everyone made or donated for me to bring here.  And I have more clothes besides the ones I wore on the plane =-)

The first photo is of one of the midwife students giving a newborn a bath before she does a thorough newborn exam.  His mom okayed me taking the photo.

The next photo is of Kenel, our Creole instructor.

Made it to Haiti

I left Homer on Thursday.  Got a  few more things in Anchorage to take with me.  Left Anchorage on Friday evening at 5:30 pm.  I was suppose to fly to Seattle, then JFK  in NY, then straight to Port au Prince, Haiti.  Weather shut down JFK for several hours.  A very nice man with Delta Airlines in Seattle helped me get to Haiti by an alternate route.  I had to RUN to get on the plane for Detroit, then flew to Atlanta, THEN Port au Prince.  I was not surprised at all that my bags did not also take the same route.  Unsure which route they are on.  Hopefully they are on there way here.

Ronel, one of the drivers for Midwives for Haiti, was at the airport to meet me.  We waited for Dr. Alice Hirata, Dr. Steve Eads, and Nadene Brunk, CNM, who were at meeting.  They arrived earlier the same day from Richmond, Virginia.  Nadene is one of the founders of Midwives for Haiti. After we were all together, we began the three our drive upcountry to Hinche.  By that time I'd been up for 33 hours.  It was fascinating to observe the people, towns and country side, but I have to admit that I did nod off a couple of times on the drive.

Everyone here at the house is VERY nice.  Carrie Wortham is the incountry coordinator.  She's a sweet girl.  She is also from Virginia and has been working here since she graduated from college last spring.  She gave me a tour of the house:  classroom, dining area, kitchen, bedrooms, upstairs office, etc.  It's really a compound.  They have security guys that also help with maintenance projects around the house and property.  They have a bunk room in the building where the supplies are stored.  There are also a couple of women that prepare lunch and dinner each day.  I believe they also do housework.

This morning Carrie, Alice and Sarah (CPM from Portland, OR) took the pink jeep to a church service at the orphanage.  That was so much fun!  There was a lot of upbeat singing.  And we had song sheets so we could sing along also.  We then went to the market.  I bought some flip flops!  Mine are in my suitcase and it's really difficult to wear shoes and socks in this heat.  It's also difficult to wear jeans in this heat.  Thankfully Nadene loaned me one of her skirts.  We also toured the hospital.  Sorry, I took photos with my camera and not my phone, so you'll have to wait to see them after I get home and can upload to my computer.

Well, lunch is ready, so I have to sign off for now = -)

After lunch, we called the airport and my bags have arrived!  Now to arrange for someone to go the 3 hours there, pick them up and drive the three hours back here!

I will be precepting student midwives at the hospital tomorrow.  That should be interesting!  Especially since the only orientation I'll be getting is here is the hospital, this is your interpreter, here are the students and here are the patients!

My Bags Are Packed

I'm allowed two bags, 50 lbs each.  These two bags are packed to bursting with donated supplies for Haiti.  According to my scale, they're slightly under 50 lbs each, I hope so. I guess I'll try to fit into a carry on clothes and toiletries for myself :-)